Tuesday, July 5, 2011

La Unión Medical Clinic Visit

Last week, Neal Persky -- a Michigan physician, UMF enthusiast, and my dad -- visited La Unión. While I was busy at work, at his suggestion I directed him up to the local Vida Abundante health clinic to talk with Dr. Rosángel and see if there was anything he could do to help out. Over the next two days, he spent a good number of hours there and after wards I had the opportunity to review the experience with him. The following interview is written in the spirit of historical fiction; all the information is true and his responses are largely formed from verbatim quotes. Our actual conversation was much more casual, though, so I've taken some poetic license in reconstructing it in a way that I hope you'll enjoy.

Q: In two sentences, summarize the time you spent at the La Unión clinic.A: Really great. I felt like I was helpful and learned a lot at the same time; it was an eye-opening and fun experience.

Q: Great. I'll punctuate that so it's two sentences. Tell me about your expectations for the Vida Abundante clinic.A: Well, judging by the other health centers we'd seen [he and I had spent the previous weekend in the La Ceiba area where we had seen a couple other "clinics"] and knowing that La Unión isn't a wealthy region, I was honestly prepared for a bare-minimum kind of institution to say the least, both in terms of resources and staff. As it turned out, I was right to expect that in certain respects, but overall I was very wrong and very impressed.

Q: Please elaborate.A: The greatest limitation I saw was the availability of medication and diagnostic tests. Unsurprisingly they didn't have the newer medicines, but I also found that they didn't have many of the generics that should be inexpensive and can be really critical for many treatments. The facilities were certainly not extravagant and relatively low-tech, but for the most part the clinic was actually relatively well equipped. What impressed me most, though, was the skill of the staff, particularly Dr. Rosángel, who I had the pleasure of speaking with at some length. Not only was she very knowledgeable, she also does a remarkable job adapting and improvising to treat a wide range of problems from mild to severe, and pediatric to geriatric without the aid of any specialists and very limited resources.

Q: Can you tell me in a little more detail what you and Dr. Rosángel talked about?A: We spent the majority of the time talking about the most common health issues she sees, her most complex cases, and how treatments vary between Honduras and the States. I was able to offer some advice on different ways to treat diabetic patients since that's one of my areas of expertise. However, in general treatments were largely similar, although she was forced to be creative in some cases, as I mentioned before.

Q: Briefly describe the most interesting patient you saw.A: A middle-aged man came in with severe shortness of breath. After speaking with him for a while, we found that he had a longstanding history of alcohol abuse, although he had reportedly stopped drinking seven months prior. He was yellow with jaundice, and after a brief examination we found that he had fluid in his lungs, major cardiac problems and severe liver failure. We discussed the diagnostic and treatment options available at the clinic, but given his complex symptoms we decided he would be best served by transfer to a tertiary care center [a major medical center].

Q: Any last words?I'd just like to thank Dr. Rosángel for sharing her time with me. I hope she found my input helpful. I really enjoyed my time there.

Dr. Rosángel also mentioned the difficulty of preventive care, which is an area UMF has been working to address. There are two major health issues in the area: disease carried by contaminated water, and respiratory illness from the massive amounts of smoke in homes produced by poorly designed wood-burning stoves. UMF is involved in facilitating group service projects to address these concerns. Using data collected last year in a needs-based survey, we have organized projects to build latrines and install stoves with proper ventilation systems in areas where they will have the greatest impact. Given the nonexistence of insurance and the dependence on physical labor, improving health through both preventive measures and quality treatment is a critical part of poverty alleviation in La Unión.

5 comments:

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